Author Topic: Stimulant Abuse: Pharmacology, Cocaine, Methamphetamine (and Treatment)  (Read 204 times)

Offline Chip (OP)

  • Server Admin
  • Hero Member
  • *****
  • Administrator
  • *****
  • Join Date: Dec 2014
  • Location: Australia
  • Posts: 5437
  • Reputation Power: 0
  • Chip has hidden their reputation power
  • Gender: Male
  • Last Login:Today at 07:07:47 PM
  • Deeply Confused Learner
source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3056348/

Stimulant use and abuse: a primary care issue

Recent history

Stimulants, including cocaine and amphetamines, are among the most widely used and abused illegal substances in the United States. Coca chewing has a long history of indigenous use in South America 1. Widespread use of cocaine followed its isolation from coca in 1859 and a medical publication purporting its benefits in 1884. Its subsequent incorporation into patent medicines and popular beverages, e.g., Vin Mariani and Coca-Cola contributed to its profligate use 2. Rising social and medical problems raised concern in many circles and restrictions were gradually applied until the Harrison Act (1914) banned all OTC inclusion of cocaine 3. In the US, a popularity wave of cocaine began in the 1970’s followed by the crack wave of the 1980’s 4. These waves have left paths of adverse consequences, including association with the HIV epidemic, in the latter decades of the 20th century.

The first of the synthetic stimulants, amphetamine (isolated in 1887), was first popularized in the 1930’s with an OTC nasal decongestant (Bezedrine inhaler) containing the amphetamine phenylisopropylamine and the following the discoveries of clinical applications for fatigue, narcolepsy and depression 5. High availability, and popularity, led to misuse and OTC use was banned in 1957. Prescription misuse followed WWII (with common military usage) and illicit diversion of medications. Methamphetamine (isolated in 1919) use peaked during the late 1960’s creating a “speed scene.” The passage of the Controlled Substances Act in 1971 led to a dramatic decline in prescribed amphetamine and the popularity of amphetamines and methamphetamine declined for a time 6. The 1990’s brought a reemergence of methamphetamine, particularly to the western US, concurrent to mounting small scale production, aka “meth labs,” first in California and subsequently spreading nationwide 7. New forms of methamphetamine, e.g., “crank” and “ice,” have had their popularity waves as well. The popularity of amphetamines is reciprocal with cultural representations throughout the 1940’s – 1990’s, e.g., in literature, movies and music 8, 9.

Table 1


Medical complications of stimulant use


Organ systemAcute complicationsChronic complications
Central nervous systemHallucinations, esp. tactilePsychotic symptoms
DyskinesiaCerebrovascular disease/stroke
SeizuresMovement disorders, e.g., dystonic reactions, akathisia, choreoathetosis, tardive dyskinesia
Cardiovascular systemTachycardiaMyocarditis
HypertensionCardiomyopathy
Myocardial infarctionMyocardial fibrosis
ArrhythmiasMyocardial infarction
PulmonaryCough, shortness of breath, wheezingInterstitial pneumonitis
Pulmonary edema, hemorrhageBronchiolitis obliterans
Pneumothorax
RenalRenal ischemia
Renal failure
GastrointestinalReduced gastric motilityGastric ulceration and perforation
Intestinal infarction
Ischemic colitis
LiverViral hepatitis secondary to contaminated syringe use
EndocrineReduced prolactinInc, normal or dec. prolactin
Increased epinephrine, CRH, ACTH, cortisol and luteinizing hormonesNormal testosterone, cortisol, LH, thyroid hormones
MusculoskeletalMovement disorders (see CNS)Rhabdomyolysis
Head and neckRhinitisRhinitis
Perforated nasal septum
Nasal and gingival ulceration
Sinusitis
Dental decay and periodontal disease
Xerostomia
Corneal ulcers
Immune systemVasculitis sysndromes
Sexual functionErectile dysfunction
Irregular menses
ReproductiveVaginal bleedingFDA category C
Abruption placentaPlacenta previa
Premature rupture of membranesLow birth weight
General/otherDehydrationWeight loss
Nutritional deficits

see the source link for the full study
Over 90% of all computer problems can be traced back to the interface between the keyboard and the chair !

Tags:
 

Related Topics

  Subject / Started by Replies Last post
1 Replies
1061 Views
Last post January 20, 2015, 07:30:32 AM
by smfadmin
3 Replies
1587 Views
Last post August 20, 2015, 06:00:32 AM
by Sand and Water
0 Replies
1061 Views
Last post August 28, 2015, 07:11:58 PM
by Chip
8 Replies
2313 Views
Last post November 11, 2015, 07:10:35 AM
by Chip
3 Replies
1207 Views
Last post July 06, 2016, 07:34:21 PM
by DeadCat
0 Replies
871 Views
Last post October 03, 2016, 12:16:56 AM
by Chip
0 Replies
670 Views
Last post September 11, 2017, 08:51:47 PM
by Chip
0 Replies
559 Views
Last post February 06, 2018, 05:41:26 AM
by Chip
1 Replies
536 Views
Last post March 08, 2018, 02:22:09 PM
by limerence
2 Replies
527 Views
Last post May 01, 2018, 03:19:53 PM
by limerence




TERMS AND CONDITIONS

In no event will d&u or any person involved in creating, producing, or distributing site information be liable for any direct, indirect, incidental, punitive, special or consequential damages arising out of the use of or inability to use d&u. You agree to indemnify and hold harmless d&u, its domain founders, sponsors, maintainers, server administrators, volunteers and contributors from and against all liability, claims, damages, costs and expenses, including legal fees, that arise directly or indirectly from the use of any part of the d&u site.


TO USE THIS WEBSITE YOU MUST AGREE TO THE TERMS AND CONDITIONS ABOVE



Founded December 2014